Revision TKR Sondrals’ Revision

[sondrals]

Home and they say everything went well. They said they removed a good bit of scar tissue as well as did the release. I’ve actually been home since 11am but I was zonked and took a nap after eating a little something. Bf ordered dinner delivered and I’ll probably retreat to the bedroom for more ice, elevation, and napping. I can walk fairly well but they gave me a nerve block so I have to be super careful as it all the sudden kinda just collapses. That’s going away as the nerve block wears off but I’m still being very careful. Overall no pain but suspect the nerve block is mostly responsible for that. Keeping up on my meds as I don’t want to be behind it when the block wears off.

 

[Jamie]

You're doing everything just right. It's smart to be careful with your knee until the nerve block completely wears off. After all this, you don't want to risk a fall!

 

[sondrals]

Yup. 100% do not want to fall. Using my walker full time at least until I go back for my appointment Monday. Kinda surprised it can bend it as well as I can. I really was expecting a hugely swollen immobile knee and this really isn’t like that at all. So pleasantly surprised, at least for now

 

[Celle]

I'm glad you're feeling better than you expected, Sondra.

You probably know these by heart now, but here's another copy of the recovery guidelines, just in case you need a reminder:
Knee Recovery: The Guidelines
1. Don’t worry: Your body will heal all by itself. Relax, let it, don't try and hurry it, don’t worry about any symptoms now, they are almost certainly temporary
2. Control discomfort:

rest​

elevate​

ice​

take your pain meds by prescription schedule (not when pain starts!)​

don't overwork.​

3. Do what you want to do BUT

a. If it hurts, don't do it and don't allow anyone - especially a physical therapist - to do it to you​

b. If your leg swells more or gets stiffer in the 24 hours after doing it, don't do it again.​

4. PT or exercise can be useful BUT take note of these

the BoneSmart view on exercise​

BoneSmart philosophy for sensible post op therapy​

5. Try to follow this

Activity progression for TKRs​

6. Access to these pages on the website

Oral And Intravenous Pain Medications​

Wound Care In Hospital​

The Recovery articles:
The importance of managing pain after a TKR and the pain chart
Swollen and stiff knee: what causes it?
Energy drain for TKRs
Elevation is the key
Ice to control pain and swelling
Heel slides and how to do them properly
Chart representation of TKR recovery
Healing: how long does it take?
Post op blues is a reality - be prepared for it
Sleep deprivation is pretty much inevitable - but what causes it?

There are also some cautionary articles here
Myth busting: no pain, no gain
Myth busting: the "window of opportunity" in TKR
Myth busting: on getting addicted to pain meds

We try to keep the forum a positive and safe place for our members to talk about their questions or concerns and to report successes with their joint replacement surgery.

While members may create as many threads as they like in the majority of BoneSmart’s forums, we ask that each member have only One Recovery Thread. This policy makes it easier to go back and review the member’s history before providing advice, so please post any updates or questions you have right here in this thread.

 

[sondrals]

So my bandage is so bulky I can’t really feel any cold through it. Suggestions?

 

[Jamie]

You may not feel it, but the cold from your ice packs is getting through. You won't have that bulky dressing on very long, so this is a time you just need to wait it out. Be sure you are icing as much as possible, though....day and night.

 

[sondrals]

I’ve fought my dang bandage all weekend. All it does is slide down my leg and my instructions say not to take it off. What a pain it’s been. I don’t have much pain but I just feel.... gross. My stomach will not settle down and I feel lightheaded sometimes. I think I’m dehydrated because I haven’t been able to keep any food in me until today. Sleeping lots and I go back tomorrow to get the bandage removed. What a relief that’ll be.

 

[Jamie]

Boy, that is frustrating about the dressing! Thank goodness you'll have a smaller bandage soon. That will make icing easier too. You're doin' great.....keep hanging in there!

 

[sondrals]

Finally got my bandage off this morning. The nurse gave me gold stars for leaving it on but told me if it were her she would have gotten rid of it. It wasn't over my knee really anymore and was acting more like a shin guard than anything. The PA came in and showed me pictures of what all they did, I nodded like the pictures didn't look like some unknown blob and I could totally see what he was pointing at.

My knee cap now. shifts over, which is sort of weird. The PA said that's... expected and not to freak out. He said I need to strengthen the muscles to hold my kneecap where it needs to be now. But he doesn't want me starting physical therapy until at the earliest next week. But... of course, I'm freaking out. This has been such a long long road and seeing it move like that... super weird and disconcerting. *sigh* I really hope someday this entire saga is over and I can just stop thinking about my knees 24/7

 

[Jamie]

This is all great news, @sondrals! Your surgeon is absolutely on target with his gentle approach to you resuming therapy to strengthen. Healing first, THEN work on muscle strength. I know it's difficult to be patient when it seems like you've been in the "world of knees" forever, but this really is the perfect way to achieve the recovery you're looking for. Continue to take things very slow and easy. Think ahead to spring and a time when you'll be feeling much stronger and happier. It's coming.....

 

[sondrals]

Is it normal for the interior of my leg, mostly in the calf, to still be numb? Guess I’m getting worried there might be nerve damage or something

I should add it kinda feels... like it’s on fire a burning sensation. But it’s not hot to the touch. And kinda tingly and itchy (though that may be dry legs).

 

[Jamie]

The numbness can hang around for quite a while. You're still pretty early in your recovery yet....not even a month out. Please try not to worry about nerve damage. If that burning sensation is severe or constant, you could contact your surgeon's office. It's really normal to feel a lot of different pains that move around as you heal.

 

[sondrals]

I mentioned it when I was in last week and they prescribed Gabapentin. Which has mostly resolved the burning feeling but not the numbness. Guess I’ll just have to wait and see.

 

[sondrals]

Oh and I went to pt today to work on well... walking and out of curiosity we measured my rom in both legs, 125 in my right, 124 in my left. Pretty happy about that

 

[Celle]

You're doing well, Sondra. It sounds as if your recovery is going as it should.

 

[sondrals]

So I've generally been ok with going to PT... I'm not happy with where I'm at but I continue to go and try to work on things. We work a lot on "walking" I still am struggling with putting full weight on my left leg and I still walk with a limp when I don't use my cane. I'm pretty frustrated and don't feel like I'm making much progress most the time, but my physical therapist assures me things are getting better, they can see it.

That being said last week she mentioned I should probably go to some kind of mental health counseling. I didn't really think much of it at the time and kind of brushed it off but now I'm a little bit hurt and offended. Like, there's something wrong in my brain that's making me not be able to walk correctly? Maybe I'm being hyper sensitive, maybe I'm not. But it's really discouraged me, like there's nothing wrong with my leg, I'm just a mental case that can't get over myself. I don't really want to stop going to PT because I do sometimes think it's helping. But this being the 3rd physical therapist.... I feel like I get to some point and I'm not progressing fast enough so I get brushed off as being mental. Though the last two times there WAS something wrong! And I was ignored despite saying it felt like my leg was slipping.

So I kind of don't really know what to do. I don't really want to keep going if it's just going to be pushed off on me not being able to walk properly because I'm crazy. Nor do I really want to pay $100/week for someone who's already given up on me. I don't really want to search for a new physical therapist but I do feel like I am getting stronger and benefiting from what I'm doing there, and I don't seem to be able to accomplish the same things at home so I don't really want to totally quit.

Also my right leg is still almost completely numb on the inside from my knee to my ankle. It's rather concerning to me and I plan on bringing it up at my follow up on the 2nd of February, assuming anyone will listen.

 

[Jockette]

I’m sorry that your PT is not more supportive of you, both in the physical aspect, as well as the emotional aspect.

Both your legs have had multiple surgeries, in a relatively short time, less than a year and a half. I think that has a lot to do with our healing rate. I was still not “recovered” from my one “little partial” at a year and a half post op. I saw improvement well into my third year post op.

I think a lot can happen to us emotionally with this recovery. I admit to having some PTSD as a result of my experiences in recovery. Time has also helped those feelings settle down a bit.

My outcome has been a poor one, but it‘s manageable. I’ve had 2 second opinions and neither doctor found anything to fix, though they didn’t look very far, so I understand your feeling that they are not listening to you. I bet if their leg felt like mine does, they‘d put more effort into finding a solution. And if they had been through all you have been through, they’d be more understanding. Too many in the medical field truly don’t fully understand the healing process, and how individual it is. My trust level is pretty low at this point, so I’m just managing with what I have, and I’m thankful it isn’t any worse.

I don’t have a solution for you, but I understand where you’re coming from. Hopefully more time to heal will help you the way it has helped me.

 

[sistersinhim]

I think what your therapist said is awful. You are still walking with a limp because your left knee is only less than 4 months old. That's 1/3 of the way healed. Add to that all the other surgeries you have been through...no wonder you are walking with a limp. Your PT is expecting too much too soon and is not helping you at all by putting the blame on your 'mental' problem. Baloney! Tell her there is nothing wrong with your brain, it's your knee because it's still a baby. You don't need anyone like that. You're better off doing your own therapy.

 

[Jamie]

sistersinhim is absolutely correct. It's easy (even if you're a trained physical therapist) to minimize recovery from a problem knee. It takes longer than a primary surgery that is very straightforward with no problems at all. Unfortunately, your current therapist doesn't understand this. If you want to stay with her, I'm afraid you'll just have to overlook this lack of understanding.

I'm proud of you for recognizing in your gut that the therapist's comments were out of line and incorrect. Since you don't have that much longer before you see your surgeon again, I suggest you continue with the therapist if you feel you are benefiting from it. Then when you see your surgeon, talk to him about it and see what he recommends for additional therapy. Whether you do or do not need mental counseling, it was totally unprofessional for a therapist to say something like that to a patient. If she felt you needed this type of help, she should have made a report back to the surgeon documenting why she felt that way.

You have some options if you want to continue to see this therapist. At your next appointment, you can bring it up, remind her that she is not trained in mental health diagnosis, tell her you were offended and ask that she stick to physical therapy issues from now on. Or....if you are not comfortable bringing this up to her, you could wait and have this conversation if she ever mentions it again. It also wouldn't hurt to talk to her supervisor about it as well.

This is one of those cases where you are entitled to stand up for yourself and the way you are treated by those on your medical team. If you provide this feedback to the therapist, her supervisor, and your surgeon, it signals that you recognize she was out of line and you are concerned this might happen to others who may be more vulnerable than you are.

Try not to worry about your knee. You're still in the very early stages of your recovery. Use your walking aids as long as you need them. There is no hurry. You want to keep working WITH your knee as it heals, not fight against what it needs. Keep reminding yourself that your knee is in control and it will heal.

 

[sondrals]

Saw the surgeon yesterday. He said my right is tracking much better and watched me walk. Said not to give up yet (jokingly said to wait a month or two then give up). Had PT today and after a long day at work and then just flat out getting frustrated with myself over not being able to walk. I cried the whole way home in the car. And I’m still barely keeping it together even now. I’m so frustrated at having to use a cane. And I know I’m vaulting myself off my right leg when I walk but I don’t know how to fix it. And I have no one to talk to that would even begin to understand and it wouldn’t turn into a fight over. I want to throw my cane, walker and bath chair at something and break them all. I am so incredibly sick of all of it.